Medical staff at Long Beach’s St. Mary Medical Center is in turmoil, as its leaders believe the entire anesthesiology and radiology departments could be effectively laid off by the end of the month — and as far as the doctors know, there’s no one waiting in the wings to replace them.

Doctors who have spoken to the Press-Telegram said they believe the potential move by hospital administration could be an act of retaliation, as some leaders in those departments have been critical of how decisions made by Dignity Health, the healthcare company that operates St. Mary’s, could affect patient care. If that were the case, the move would be a violation of state law.

“At St. Mary Medical Center, providing high-quality patient care in a safe environment is always our top priority,” St. Mary Medical Center President Carolyn Caldwell said in a statement. “The hospital is committed to working with its medical staff, and is in compliance with all of the regulatory requirements that assure that the medical staff is a valued partner in the review of all medical services contracted by the hospital.”

The allegations against Dignity Health

Douglas McFarland, the chief of staff for St. Mary’s Medical Executive Committee, said in a phone interview that Dignity Health’s actions so far have been so egregious that the medical staff would “absolutely” be willing to sue.

“There are a few different state business statutes that we believe have been broken,” McFarland said. “The entire medical staff is willing to dig deep into reserve funds to potentially sue Dignity. It’s kind of scary, considering their deep pockets, but I think it’s doing the right thing.”

But before any lawsuit is filed, the medical staff have initiated a dispute resolution process with the administration, in the hopes that, somehow, those doctors’ contracts can be renewed.

A letter obtained by the Press-Telegram that was sent to the entire St. Mary’s medical staff on Wednesday, Feb. 6, alerted staff members to a decision by the Medical Executive Committee — a body of doctors who were elected by their colleagues to represent them and patients in discussions with hospital administration — to begin the mandated dispute resolution process.

The letter details the points of dispute, all of which the committee claims are in violation of state law. The main points of contention are:

The administration’s alleged refusal to discuss with medical staff leaders how the positions would be filled;

The administration’s decision to terminate long-held contracts because of alleged retaliation;

The administration allegedly interfering with the Medical Executive Committee by potentially terminating the contract of its Vice Chief of Staff, who is a radiologist.

The potential short-term impacts

Doctors described recent years under Dignity Health’s leadership as chaotic, with frequent leadership turnover. Now, they said, it appears that tumult could be trickling down and taking doctors along with it, which they said would ultimately have an adverse impact on patient care.

“In 20 years, I’ve seen eight CEOs and changes in administration,” said Mauricio Heilbron Jr., a surgeon at St. Mary’s. “There’s turnover, and it’s made worse because one of the CEOs stayed almost 10 years. It happens a lot, but there is something different about the current administration.”

Heilbron said hospital leadership has quietly moved toward eliminating the two departments, a total of 12 to 14 doctors, by terminating their contracts, which end Feb. 28. Doctors in those departments have been notified of the decision and that a new group of doctors will be replacing them. Heilbron said other departments would likely follow.

Even in a scenario in which the anesthesiology and radiology departments were eliminated and replaced with a smooth transition, McFarland said patients could still face the brunt of that decision.

“I’m not sure that you can hire one group of doctors and say that everybody will be comfortable with the care that they’re providing just because they’re licensed,” McFarland said. “There’s a lot of bad doctors out there practicing, and I suspect most of them are the ones that would be willing to work for less money than our higher quality doctors.”

But Heilbron worries the more likely scenario would be even worse. He said that despite the administration’s warning that a new group of doctors will be coming in, no one has yet applied to fill those jobs — and that hiring would require a lengthy vetting process. Because of that, he said, the hospital’s operating room would likely shut down on March 1.

The possible long-term impacts

Heilbron said he doesn’t believe the administration is aware of the long-term impacts of its decision-making, but he hopes the entire medical staff’s decision to band together will help them understand what could unfold.

“This administration has just done something that we’ve never experienced before, and I don’t think they know what they’re doing,” he said. “Every physician in this hospital is afraid this hospital could go under if they continue doing this.”

After Community Hospital shuttered, St. Mary’s touted its ability to make up some of the difference in bed space.

“What is Long Beach going to do with only one functioning hospital?” he said, referring to MemorialCare Long Beach Medical Center. “Memorial wouldn’t be able to handle it. This would cripple the community.”

Heilbron said the doctors are typically difficult to organize — “herding cats” was his term of choice — but because many of the doctors who would be impacted have served Long Beach for more than 20 years, standing together on this was an easy call.

“This caused such an uproar that all the physicians got together and decided: We need to make this stop,” he said.

Could this be the beginning of a new era?

Meanwhile, McFarland is concerned that this breakdown between medical staff and hospital administration could just be part of a new, worrisome trend in healthcare, spurred on by large healthcare companies merging to become even bigger.

“They have a bottom line to protect, and physicians are becoming less powerful in their attempts to kind of advocate for patients,” McFarland said. “I know that with the Dignity merger, we’re entering into a new era of really big hospital business, and for a small community hospital like St. Mary’s, that makes it kind of rough to continue to practice medicine in the way we have for so long.”

But for now, the medical staff at St. Mary’s is hoping it can circumvent what they see as a looming crisis — and avoid litigation, if possible. If not, McFarland said, it may take a larger group of doctors to make an impact in this new era.

“Hopefully, we’ll never get there,” McFarland said. “But if we did (sue), I think we could probably reach out to a lot of hospital-based physicians groups and make this a bigger, precedent-setting lawsuit.”

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Hayley Munguia covers Long Beach City Hall for the Southern California News Group. She previously worked as a data reporter for FiveThirtyEight and has written for The Week, the Jerusalem Post and the Austin American-Statesman, among other publications. She's originally from Austin, graduated from NYU and will pet a dog any chance she gets.

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